Venereal syphilis in tropical Africa.

A steady decline in the incidence of positive results to the Kahn test is reported in Malawian patients during the period 1968-75. Other studies have shown that the incidence of early and late syphilis in sub-Saharan Africa has dropped considerably over the past few decades. The number of reported cases of early syphilis in certain urban areas, however, appears to be high. It is suggested that the downward trend in the incidence of syphilis in Africa is related to the increased and often indiscriminate use of penicillin.     

Pregnancy loss, infant death, and suffering: legacy of syphilis and gonorrhoea in Africa.

Africa in the 1980s appears to be facing problems associated with syphilis and gonorrhoea during pregnancy similar in severity and magnitude to those faced by the western world in the early 1900s. From a review of published reports, the prevalence of syphilis seroreactivity in pregnant women in many parts of Africa is at least 10%. Assuming this level of seroreactivity, we estimate that 5% to 8% of all pregnancies surviving past 12 weeks will have an adverse outcome caused by syphilis, such as spontaneous abortion, perinatal or infant death, or a living infant with syphilis. Our findings on gonorrhoea during pregnancy are almost as startling. The prevalence of gonorrhoea in pregnant women in many parts of Africa is at least 10% and it approaches 20% in some areas. The incidence of gonococcal ophthalmia neonatorum in neonates appears to be between 2% and 4%. We recommend commitment of health resources to initiatives to prevent and control sexually transmitted disease in Africa and additional research into the cost effectiveness of different prevention and control approaches.     

1990年全国38个城市监测点梅毒流行病学调查报告

总给了1990年全国24个省(市)38个性病监测点梅毒流行病学调查资料.一年中,总计发现梅毒病人809例.平均年发病率为0.75/10万人、男性发病率(0.97/10万)明显高于女性(0.52/10万),新祖、陕西、甘肃和河北等省区的发病率较其他省区为高.本组梅毒病人多为性活跃年龄者,20-39岁年龄组患者占73.54%.对性和性行为的态度有明显改变.患者中初中以下文化程度占71.32%.早期梅毒占97.21%(787例),三期梅毒1.65%(l3例),先天梅毒1.14%(9例).     

佛山市2004-2013年梅毒流行病学分析

目的：了解佛山市2004-2013年梅毒流行病学特点,为制定防治策略提供科学依据。方法：采用Microsoft Excel 2010及SPSS15.0对2004-2013年佛山市梅毒疫情资料进行描述性流行病学分析。结果：2004-2013年佛山市累计报告梅毒病例47 632例,其中后天梅毒45 458例,年均报告发病率为64.94/10万,年报告发病率缓慢上升,2012年达到高峰;Ⅰ＋Ⅱ期梅毒年报告发病率曲线平缓;隐性梅毒年报告发病率与后天梅毒报告发病率变化基本一致;近十年胎传梅毒共报告2 174例,年均报告发病率为217.4/10万活产数,2004至2007年报告发病率呈上升趋势,2007年后呈波动下降趋势;年龄组别报告病例数最多的是30-39岁年龄组;报告病例数居前三位的职业分别是工人、家务及待业、农民;顺德区和南海区病例数最多。结论：青壮年是梅毒重点防治人群,但老年人群也不容忽视;要加强孕期妇女的梅毒筛查,减少胎传梅毒的发生;同时应加强梅毒监测,继续开展有效的干预措施控制我市梅毒的流行。     

2014—2019年中国梅毒流行趋势与特征分析

【摘要】 目的 分析2014—2019年中国梅毒流行趋势和特征,为制定防治对策提供依据。方法 应用描述性流行病学方法对2014—2019年中国梅毒报告病例数据进行“三间分布”分析。结果 2014—2019年,梅毒报告发病率由30.93/10万增长至38.37/10万,年均增长4.41%;其中一期与二期梅毒、胎传梅毒报告发病率年均下降10.95%和26.16%,三期梅毒和隐性梅毒年均增长1.61%和10.75%。高发省份为新疆、青海、浙江、海南和福建等。各年男性梅毒报告发病率略低于女性,男女性别比为0.86∶1～0.96∶1。15～19岁组呈逐年快速增长趋势,年均增长13.54%。2014—2018年梅毒高发年龄段为25～34岁,2019年为20～24岁。各职业人群均有病例报告,以农民和民工最多,占41.19%～46.80%,学生人群增幅最大,年均增长20.72%。一期与二期梅毒构成比逐年减少,隐性梅毒构成比逐年增加,2019年达82.95%。结论 2014—2019年中国梅毒总报告发病率逐年增长,一期和二期梅毒报告发病率下降;年轻人群报告发病率快速增长;农民、民工为重要受影响人群;高发地区为西北部分地区和东南沿海部分省份。     

Effect of highly active antiretroviral therapy on incidence of early syphilis in HIV-infected patients

OBJECTIVES: To evaluate the incidence of early syphilis based on time from initiation of highly active antiretroviral therapy (HAART) in human immunodeficiency virus (HIV)-infected patients. STUDY DESIGN: Five hundred thirty-nine HIV-positive patients undergoing HAART were followed up to 4 years to identify early (primary or secondary) syphilis. Incidence rate trends according to time from HAART initiation were evaluated by Poisson regression after adjustment for calendar year. RESULTS: With median follow-up of 2.9 years, 56 (10.4%) patients experienced early syphilis, 17 (3.2%) with primary syphilis, and 39 (7.2%) with secondary syphilis. The overall incidence rate of early syphilis for 4 years after the start of HAART was 4.57 per 100 person-years (95% confidence interval, 3.45-5.93). The incidence rate of early syphilis significantly increased in proportion to the years after the start of HAART (3.4-6.1 per 100 person-year, P for trend <0.001). CONCLUSIONS: Early syphilis incidence in HIV-infected patients increased in proportion to HAART duration. The finding suggests that screening for syphilis in HIV-infected patients who initiate HAART should be encouraged with attention to the time passed since HAART initiation.     

浙江省2016—2020年梅毒流行时空特征分析

目的:分析浙江省2016—2020年梅毒疫情时空分布特征,探测聚集区域,为梅毒精准防控提供理论依据。方法:从中国疾病预防控制信息系统传染病监测系统个案管理模块导出浙江省2016—2020年网络直报的梅毒病例,利用Arcgis10.2软件作为数据管理和呈现平台,建立浙江省2016—2020年梅毒空间分析数据库,对梅毒疫情...     

Recent declines in reported syphilis rates in eastern Europe and central Asia: are the epidemics over?

BACKGROUND: Since the early 1990s, major syphilis epidemics have occurred in the Newly Independent States (NIS) of the former Soviet Union. The new and rapidly changing societal and economic conditions in these countries challenge their traditional approaches to the control of sexually transmitted infections (STI). Nevertheless, following a steady increase until 1997, reported syphilis incidence has declined during the past 3 years in most parts of the region. We examine these trends against a background of ongoing changes in service delivery, care seeking behaviour, and case finding practices. METHODS: National syphilis surveillance data reported to the WHO Regional Office for Europe were compiled and analysed, and supplemented with information presented at recent expert meetings and with results from ongoing research. RESULTS: Since 1997, reported syphilis incidence either stabilised or declined in many locations in the NIS, but further increased in others, especially in rural areas. Congenital syphilis continued to increase in all countries, except Latvia. The proportion of self presenting cases versus cases detected through screening declined, and so did notifications of early compared with late forms of syphilis. Patients increasingly seek care in the private formal and informal healthcare sectors which hardly participate in case reporting. CONCLUSIONS: Recent declines in syphilis notifications in the NIS are at least partially a reflection of a reduced intensity of active case finding and of changes in reporting completeness because of a shift in service utilisation from the public to the private/informal sectors. Syphilis rates are still high, indicating that both public and private sectors have to respond more efficiently to the needs of many people at risk of STI. The collection of serial STI prevalence data is recommended to be able to validate trends in notifications.     

Bone invasion in secondary syphilis: case reports.

The affinity of treponemes for bone tissue is well known, but the incidence of bone infection in the early stages of syphilis is uncertain. Although case reports of early bone invasion are few, reviews of large numbers of patients with early syphilis indicate that the incidence is probably greater than at present believed. Two case reports are presented.     

2010-2019年广西梅毒流行特征分析

目的:了解广西梅毒流行特征和趋势,为制定防控策略提供依据.方法:对广西2010-2019年通过中国疾病预防控制信息系统传染病监测信息系统报告的梅毒病例资料进行描述性分析.结果:2010-2019年,广西梅毒年报告发病率由82.41/105降至37.24/105,年均下降8.45％;一期和二期梅毒报告发病率年均下降22....     

Venereal disease among immigrant workers in Vienna.

Official physical examinations of migrant workers upon immigration are required before work permits are issued. The screening of 74,983 applicants during 1972 to 1974 revealed sera reactive to serological tests for syphilis in 0-8 per cent. (range 0-5 to 1-1 per cent.) of all persons concerned and fifteen cases of early syphilis. The incidence of recent infections among immigrants is lower than that reported among the inhabitants of Vienna. General statistics on the spread of venereal diseases among immigrant workers are not available after they start work. Some evidence is provided by those who had to be traced for compulsory examination because they had defaulted from treatment or follow-up, because they were suspected of clandestine prostitution, or because they were reported to be sources of infection. 257 (60-6 per cent.) of 414 individuals who were wanted for reasons of syphilis control could be located and eighteen (7 per cent.) of those who were examined had early infectious lesions.     

Syphilis serologic prevalence monitoring among STD clinic clients: correlation with reported syphilis incidence, San Diego, CA, 1985-2004

OBJECTIVE: To describe the serologic test for syphilis (STS) prevalence among STD clinic clients, determine the correlation between STS prevalence trends and reported community-diagnosed primary and secondary (P&S) case incidence, and evaluate the usefulness of STS prevalence monitoring as a component of syphilis surveillance. STUDY: During the period 1985-2004, 21,4336 STS were done among STD clinic clients and a variety of STS prevalence measures were evaluated. RESULTS: From 1985-1991, 10.2% of STS were positive, which declined to 5.6% during 1992-2004. Overall, STS positivity (>or=1:8) and male positivity (>or=1:8) trends were correlated with reported community-diagnosed P&S case incidence and case incidence in men (r = 0.58 and r = 0.81, respectively). Male STS positivity (>or=1:8) began increasing in 2001, 1 year before the increase in syphilis incidence in men, which began in the latter half of 2002 and occurred mostly among men who have sex with men. CONCLUSION: In a syphilis outbreak in men who have sex with men, STS prevalence (>or=1:8) among male STD clinic clients was a useful measure of syphilis case incidence trends and may provide an early warning for a subsequent increase in community-diagnosed case incidence.     

Unusual primary syphilis: Presentation of a likely case with a review of the stages of acquired syphilis,its differential diagnoses,management, and current recommendations

Syphilis is an ancient disease that has re‐emerged in the last decade. It is prevalent among men who have sex with men and has increased in incidence with certain ethnic groups. It usually presents as primary or secondary syphilis and can progress to tertiary syphilis if not treated. Primary syphilis will classically manifest as a single, painless ulcer with smooth, clean, and raised borders on the genitals or less often on the oral mucosa. Unusual primary syphilis cases have been reported and can be easily misdiagnosed with a resulting delay of treatment. Secondary syphilis is a systemic disease, wherein the treponemes have disseminated to various organ systems, typically presenting with characteristic mucocutaneous lesions. Tertiary syphilis has a higher rate of morbidity and mortality; as such, the aim of this article is to provide the readers with tools to recognize early syphilis and prevent its progression to late stages. In this review, we present a likely case of unusual primary syphilis mimicking herpes progenitalis as well as a compilation of all atypical cases of primary syphilis from 1973 to 2015. We will also review the differential diagnosis, management, and recommendations for each stage of syphilis.     

广东省佛山市2004~2011年淋病和梅毒流行特征分析

目的:分析佛山市2004~2011年淋病和梅毒的流行特征,为制定防治策略提供科学依据.方法:对2004~2011年佛山市淋病和梅毒疫情报告资料进行描述性分析.结果:自2005年以来,淋病报告发病率呈减少趋势;在梅毒报告病例中,隐性梅毒构成比为50%,其报告发病率呈上升趋势,而Ⅰ期+Ⅱ期梅毒报告发病率呈减少趋势.淋病及梅毒报告病例中,男女性别比分别为1:0.13、1:0.85,发病均以20~39岁青壮年为主,职业构成均以工人、民工为主.报告例数主要集中在南海区、顺德区.结论:由于近年来采取有效的防治措施,自2005年以来佛山市淋病与梅毒的流行呈减少趋势,但控制梅毒母婴传播的任务依然艰巨.     

郑州市1996~2005年梅毒流行病学分析

目的寻求郑州市梅毒流行规律和特点,为制订防治政策提供依据。方法对1996~2005年郑州市梅毒病例资料进行分析。结果1996~2005年梅毒的发病率呈上升趋势。以早期梅毒为主,一期梅毒发病数高于二期梅毒;梅毒感染者主要在20~44岁年龄段,占60.05%;工人、农民、待业、商业服务、干部分别占20.44%,18.15%,11.52%,8.54%,6.25%。结论应加强梅毒防治工作力度,规范梅毒诊治,全面实施健康教育、行为干预等综合防治措施。     

Risk factors for active syphilis and TPHA seroconversion in a rural African population

OBJECTIVES: Syphilis is an important cause of morbidity in sub-Saharan Africa, and a cofactor for the sexual transmission of HIV. A better understanding of the prevalence and risk factors of syphilis in African populations would help to formulate effective interventions for its prevention and treatment. METHODS: The prevalence and incidence of syphilis were obtained from a cohort recruited in Mwanza, Tanzania. Two unmatched case-control studies nested within the cohort provide information on potential risk factors. RESULTS: The prevalence of active syphilis (TPHA positive and RPR positive any titre) was 7.5% in men and 9.1% in women, but in youths (aged 15-19 years) the prevalence was higher in women (6.6%) than in men (2.0%). The incidence of TPHA seroconversion was highest in women aged 15-19 at 3.4% per year, and around 2% per year at all ages among men. A higher prevalence of syphilis was found in those currently divorced or widowed (men: OR=1.61, women: OR=2.78), and those previously divorced or widowed (men: OR=1.51, women: OR=1.85). Among men, prevalence was associated with lack of circumcision (OR=1.89), traditional religion (OR=1.55), and reporting five or more partners during the past year (OR=1.81) while incidence was associated with no primary education (OR=2.17), farming (OR=3.85), and a self perceived high risk of STD (OR=3.56). In women, prevalence was associated with no primary education (OR=2.13), early sexual debut (OR=1.59), and a self perceived high risk of STD (OR=3.57), while incidence was associated with living away from the community (OR=2.72). CONCLUSION: The prevalence and incidence of syphilis remain high in this rural African population. More effort is needed to promote safer sexual behaviour, and to provide effective, accessible treatment. The high incidence of syphilis in young women calls for sexual health interventions targeted at adolescents.     

山东省预防与控制梅毒规划实施效果评价

目的：评价山东省预防与控制梅毒规划实施效果,为制定“十四五”规划提供依据。方法：（1）通过自上而下方式开展规划终期评估部署、指导、质控和培训。（2）按照工作任务分工,开展多部门协作收集资料。（3）保障措施情况、准确性核查、不同人群的知晓率等通过专项调查获得。专业技术人员知识掌握合格率通过携手医访APP现场考试获得。（4）通过自下而上方式开展规划自评、审核和验收。结果：16个评估指标中,在省级层面达标13个,基本达标3个。全省梅毒报告发病率自2014年后增长趋缓,年增长率2.15%。一期和二期梅毒报告发病率自2010-2014年呈上升趋势,2014年后呈下降趋势。三期梅毒报告发病率保持在较低发病水平,但呈缓慢上升趋势。胎传梅毒报告发病率于2012年前快速上升,2012年后快速下降。 隐性梅毒报告发病率呈增长趋势,但增长速度放缓。结论：山东省预防与控制梅毒规划实施取得显著效果,全省梅毒流行处于较低水平,增长趋势得到有效遏制。     

A case of early congenital syphilis

A case of early congenital syphilis is reported in order to emphasize that syphilis is still present nowadays and that detection of syphilis in pregnant women is primordial for the prevention of this disease.     

Jarisch‐Herxheimer reaction among syphilis patients in China

Background/aim The Jarisch‐Herxheimer reaction (JHR) is an acute systemic event that can occur during the treatment of spirochetal infections, especially Treponema pallidum in patients with syphilis. JHR has clinical characteristics of an inflammatory reaction to antibiotic treatment and can occur with many medications as long as the antitreponemal concentrations are sufficiently high. Methods The incidence of and risk factors for JHR were investigated retrospectively among 1125 patients with syphilis. A total of 357 patients (32%) had secondary syphilis, 129 (12%) primary, 178 (16%) early latent, 174 (15%) late latent and 285 (25%) latent unknown duration; two patients had tertiary syphilis. Results Sixteen patients (1.4%) developed JHR. All JHRs occurred in patients with secondary and latent syphilis treated with penicillin. Conclusions JHR occurred much less frequently than in previously reported studies. It is important that dermatologists recognize the clinical characteristics of JHR so that it is not misinterpreted as an allergic reaction to treatment.     

1990年至1994年全国38个城市监测点梅毒流行病学调查报告

为了全面地了解我国梅毒发生、发展和分布的特点及流行的规律,为制订控制梅毒的对策提供科学依据,我们于1990～1994年对全国38个城市监测点用统一的方法、步骤和表格作了连续五年的梅毒发病情况的调查.总计发现梅毒病例5078例,占STD构成比为1.34%,平均年发病率为0.94/10万,平均年增长率为23.06%,男性平均年发病率为1.09/10万,女性平均年发病率为0.75/10万.我国目前流行的主要是早期梅毒,占94.70%,其中一期梅毒20.16%,二期梅毒46.51%,早期隐性梅毒28.10%;此外,三期梅毒为2.10%,先天梅毒为0.70%.以20～29岁和30～39岁年龄组发病率最高,分别为1.80/10万和1.56/10万.从职业分析以个体者、待业者、驾驶员发病率为最高.我国梅毒发病率较高的地区,北方是新疆、陕西、甘肃和天津,南方是福州、桂林、杭州、南宁和海口一些旅游城市,尤其是南方城市近年来呈明显上升之趋势.作者认为:必须继续进行对我国梅毒流行的监测,加强提高梅毒诊断技术和治疗方法,加强长效青霉素制剂的生产和供应,以保证梅毒防治工作的开展.